Occurrence of fetoprotein in patients with neoplasms and non‐neoplastic diseases

Section: Resultsmentioning

confidence: 99%

Excretion of Alpha-foetoprotein in the Urine of Pregnant Rats and Hepatoma-bearing animals

Okon¹,

Rosenmann²,

Dishon³

et al. 1973

“…It is produced in several physiological and disease states and is a normal component of human foetal serum. It is produced in certain liver diseases, notably hepatocellular carcinoma (McIntire et al, 1972) and in situations where there is hepatic regeneration (Bloomer et al, 1973;Elgort et al, 1973;Masopust et al, 1968; Waldmann et al., 1974).AFP is now used routinely with human chorionic gonadotrophin (hCG) in the diagnosis of anaplastic germ cell tumours and in monitoring their response to therapy and follow-up. The production of AFP by germ cell tumours is closely associated with the histological finding of yolk sac or embryonal elements (N0rgaard-Pedersen et al, 1975;Kurman et al, 1977;Talerman et al, 1977;Grigor et al, 1977).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Problems of interpretation of serum concentrations of alpha-foetoprotein (AFP) in patients receiving cytotoxic chemotherapy for malignant germ cell tumours

Newlands¹,

Dent²,

Mitchell³

et al. 1983

Summary Serial determinations of serum alpha-foetoprotein (AFP) concentrations are well established in monitoring the response to therapy of malignant germ cell tumours. Using a radioimmunoassay (RIA) with a sensitivity down to 2 kuI-1 the majority (57%) of 28 patients with non-AFP producing germ cell tumours had measurable immunologically-reactive AFP in their serum while on treatment. Follow-up for 11-43 months (mean 27) without evidence of tumour activity indicated that this immunologically-reactive AFP was unlikely to be produced by tumour. In patients where the initial serum AFP was raised prior to chemotherapy the AFP concentration did not fall to the normal range at the end of the treatment in 16 (32%) of 41 patients. Follow-up of these patients for 9-48 months (mean 27) has resulted in 5 (12%) relapses in this group. Serum AFP >20 ku I1 three months after stopping chemotherapy was a good indicator of residual active tumour and 4 (57%/) of 7 patients in this group relapsed. The production of detectable serum AFP is probably related to the type of chemotherapy used and only 7 (14%) of 51 patients treated for gestational choriocarcinoma had detectable AFP concentrations while on cytotoxic chemotherapy. The problem of interpretation of serum AFP concentration in patients with malignant germ cell tumour stresses the need to determine whether there are differences between AFP produced by germ cell tumours and that produced at other sites as a basis for a sensitive assay system able to discriminate between them.AFP is a glycoprotein with a molecular weight of 70K daltons. It is produced in several physiological and disease states and is a normal component of human foetal serum. It is produced in certain liver diseases, notably hepatocellular carcinoma (McIntire et al., 1972) and in situations where there is hepatic regeneration (Bloomer et al., 1973;Elgort et al., 1973;Masopust et al., 1968; Waldmann et al., 1974).AFP is now used routinely with human chorionic gonadotrophin (hCG) in the diagnosis of anaplastic germ cell tumours and in monitoring their response to therapy and follow-up. The production of AFP by germ cell tumours is closely associated with the histological finding of yolk sac or embryonal elements (N0rgaard-Pedersen et al., 1975;Kurman et al., 1977;Talerman et al., 1977;Grigor et al., 1977). A high serum concentration of AFP in the absence of liver disease or pregnancy is likely to be due to an anaplastic germ cell tumour or some other AFP-producing tumour. When present the serum concentration of AFP correlates well with the body burden of AFP-producing cells. However, with more intensive and successful chemotherapy in the management of patients with metastatic germ cell tumours, this has raised problems of interpretation since AFP concentrations above the normal range may not reflect residual tumour.Correspondence: E.S. Newlands Received 25 April 1983; accepted 19 June 1983 The normal serum concentration of AFP has been variously quoted as <20 ku 11 (Javadpour, 1980); usually <16kul1-and alw...

“…of serum only. The animals were bled 1 week later according to the technique of Masopust et al, 1968). The antisera used for the screening of the sera were kindly supplied by Doctors Abelev, Sizaret and Uriel.…”

Section: Methodsmentioning

confidence: 99%

Human Alpha Fetoprotein in Body Fluids

Smith¹,

Francis²,

Edington³

et al. 1971

SINcE Pedersen (1944) described bovine fetuin, a fetal serum protein absent in adult cattle serum, similar proteins have been observed in various mammals including man (Abelev et al., 1963;Gitlin and Boesman 1967;Hull et al., 1969; Tatarinov, 1964). The importance of alpha fetoprotein (AFP) in the diagnosis of hepatocellular carcinoma was first demonstrated in mice (Abelev et al., 1963) and then in man (Tatarinov, 1964). The relatively high incidence of primary liver cell carcinoma in the tropics including Nigeria (Berman, 1951;Higginson, 1956;Edington and Maclean, 1965; British Medical Journal, 1970) provides enough material for the study of this protein. It was therefore decided to find out whether AFP could be detected in other body fluids apart from serum.In rural hospitals where facilities for serological diagnosis are inadequate, the detection of AFP in a body fluid such as urine will facilitate the diagnosis of liver cell carcinoma. Furthermore the distribution of AFP in the various body fluids could be significant in elucidating its physiological role in normal and abnormal conditions. MATERIALS AND METHODSBody fluids.-Blood bile, cerebrospinal fluid (CSF) and meconium were obtained from 12 aborted fetuses, between 20 and 40 weeks gestation. Duodenal juice, rectal faeces, pericardial fluid, blood, bile and CSF were obtained from 20 neonates whose ages ranged from 1 hour to 1 month. Six AFP positive liver cell carcinoma patients and three AFP negative ones, aged between 24 years and 50 years, were also included. There were five pregnant women dying from various diseases. These provided the amniotic fluid and breast milk as well as some of Request for reprints should be directed to Dr. J. A. Smith.